Medical politics in ancient Greece

Why were the Greeks the first to put medicine on a scientific footing? Alcmaeon (fl. 470 BCE) and Hippocrates (ca. 460 – ca. 370 BCE) were giants in the field, and Hippocrates at least has become a household name.

Part of the explanation has to do with Greek religion’s naturalism, in contrast to most other religions’ other-worldly supernaturalism. And part of it has to do with early Greek philosophy’s emphasis upon observation and reasoning about nature.

But part of it also was a consequence of Greek politics. Roy Porter, in his wonderful The Greatest Benefit to Mankind: A Medical History of Mankind (W.W. Norton & Company, 1997), makes this point:

porterroy-the-greatest-benefit-to-mankind-100x151“This separation of medicine from religion points to another distinctive feature of Greek healing: its openness, a quality characteristic of Greek intellectual activity at large, which it owned to political diversity and cultural pluralism. In the constellation of city states dotting the mainland and the Aegean islands, healing was practiced in the public sphere, and interacted with other mental pursuits. There was no imperial Hammurabic Code and, unlike Egypt, no state medical bureaucracy, nor were there examinations or professional qualifications. Those calling themselves doctors (iatroi) had to compete with bone-setters, exorcists, root-cutters, incantatory priests, gymnasts and showmen, exposed to the quips of playwrights and the criticism of philosophers. Medicine was open to all (as later in Rome, slaves sometimes practised medicine)” (pp. 53-54).

A little later, Porter continues:

“What is clear is that in classical Greece philosophical speculations about nature became enmeshed in dialogue with medical beliefs about sickness and health; dialogue and debate were integral to Greek intellectual life. Unlike healing in the Near East, elite Greek medicine was not a closed priestly system: it was open to varied influences and accessible to outsiders, guaranteeing its flexibility and vitality.

“This openness followed from the fact that Greek civilization developed in multiple centres from Asia Minor to Sicily, and no single sect of doctors possessed a state or professional monopoly, Athens was the first city to support a fair number of full-time healers making a livelihood out of fees, and, according to his younger contemporary Plato (427-347 BC), the great Hippocrates taught all who were prepared to pay” (p. 55).

So there we have it: the profit motive combined with intellectual, economic, and political freedom. Let there be a lesson in that.

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